Provider Directory

You recently received a new member ID card from us. The ID card has a wrong phone number listed for Member Services. The correct phone number is 1-866-959-2555. Everything else on your card is correct. We will be sending you a new ID card soon.

We are sorry if this has caused you any difficulty in reaching us. We are available to help you Monday – Friday, 8am – 5pm.

We have a large network of doctors, hospitals, and specialists who are committed to providing you with good medical care. Our health plan was founded on the belief that you and your primary care provider (main doctor) are the 2 best qualified to care for your health. Think of your main doctor as your medical home. If you are sick, need a checkup, or if you have a medical question, call your main doctor.

Referral Process

Your primary care provider will give you all your routine medical care and will refer you to a specialist or hospital when needed. A referral is when your primary care provider arranges for you to go to another doctor. He or she will tell you exactly what kind of specialist or tests you need for your illness or condition.

Most of the time, you will need to go to your primary care provider first. If you choose to go to another doctor, you might have to pay for the services. Remember—always take your Texas Children’s Health Plan ID card and Your Texas Benefits Medicaid Card with you each time you get health care.

Other services that do not require a referral from your primary care provider

There are other certain types of health care that you can get without being referred by your primary care provider.

Those services include (when given by a Texas Children’s Health Plan network provider):

Emergency care

OB/GYN care

Prenatal care

Behavioral health services or drug and alcohol treatment

Texas Health Steps medical and dental checkups

Family planning services

Vision care

Mental health or substance use services

To pick a main doctor, you can use our online “Find a Doctor” tool here, or you may click on one of the following links to open our provider directory. If you need help or have questions, please call Member Services.